Urology Directorate
PATIENT INFORMATION
Flexible Cystoscopy
The aim of this leaflet is to explain the procedure of flexible
cystoscopy and to let you know what to expect when you come
into hospital for it to be performed.
What is a cystoscopy?
A cystoscopy is where a doctor looks into the bladder with a special telescope called a
cystoscope.
What is the difference between a flexible and a rigid cystoscopy?
There are two types of cystoscope: - a flexible one and a rigid one.
A flexible cystoscope is a thin flexible,
fibre optic telescope, that can be used
to view the bladder through the urethra
with the patient awake. It is about as
thick as a pencil. The fibre optics allows
a doctor to see around bends.
A rigid cystoscope is a thin, solid
straight telescope that can be passed
into the bladder, through the urethra. A
rigid cystoscopy is performed under
general or spinal anaesthetic and allows
various minor procedures to be
performed at the same time. Such
procedures may include taking tissue
samples (biopsies), or destroying
abnormal tissue with heat (diathermy),
or inserting/removing stents into the
ureter, or removal of bladder stones.
PIF 1207 / V1
When is a flexible cystoscopy done?
A flexible cystoscopy is a diagnostic procedure and may be done to help to find the cause of
symptoms such as:
 Frequent urinary tract infections.
 Blood in your urine (haematuria).
 Incontinence.
 Unusual cells found in a urine sample.
 Persistent pain when you pass urine.
 Difficulty in passing urine (which may be due to prostate enlargement or a stricture
(narrowing) of the urethra).
Flexible cystoscopy may also be done to monitor progress of conditions. For example, some
people have a routine flexible cystoscopy every now and then after treatment for a bladder tumour.
This helps to detect any early recurrence, which can be treated before it spreads further.
Often a flexible cystoscopy is normal. However, this helps to rule out certain causes of your
symptoms.
How do I prepare myself for a flexible cystoscopy?
No special preparation is needed. When you come to hospital you should bring a dressing gown
and slippers. We will provide light refreshments. You should bring reading material because you
are likely to wait for a time in the department.
What happens during a flexible cystoscopy?
Flexible cystoscopy is done as an outpatient. It is done while you are awake.
You will be asked to put on a hospital gown in a private cubicle and lie on your back on a couch.
The opening to your urethra (at the end of the penis or the outside of the vagina) and the nearby
skin will be cleaned. Some “jelly” is then squirted into the opening of the urethra. The jelly helps to
lubricate the urethra ,allowing the cystoscope to pass into the urethra with as little discomfort as
possible.
The doctor will then gently move the cystoscope up into the bladder. The doctor will look carefully
at the lining of the urethra and bladder. Sterile water is passed down a side channel in the
cystoscope to slowly fill your bladder. This makes it easier for the doctor to see the lining of the
bladder. As your bladder fills, you will feel the urge to pass urine, which may be uncomfortable.
A flexible cystoscopy takes about 5-10 minutes. You may be able to watch the procedure on a
television at the same time as the doctor. It may last longer if the doctor does a procedure, for
example, take a biopsy (small sample) from the lining of the bladder. The cystoscope is then
gently removed.
Your doctor may tell you what they saw inside your bladder straight after the test. If you had a
biopsy taken, the sample is sent away to be tested and looked at under a microscope. It can take
several weeks for the report of the biopsy to come back to the doctor.
What can I expect after my flexible cystoscopy?
After the test is completed you will return to the waiting room. You will be offered a drink and
biscuits.
When will I be able to go home?
You will be allowed to leave the department once you have passed urine.
Are there any side effects or possible complications?
Most cystoscopies are done without any problem. For the next 24 hours you may have a mild
burning feeling when you pass urine, and feel the need to go more often than usual. Also, your
urine may look pink due to mild bleeding, particularly if a biopsy was taken. Occasionally, a urine
infection develops shortly after a cystoscopy. This can cause a fever (high temperature) and pain
when you pass urine. Rarely, the cystoscope may damage the urethra causing delayed scar
formation (urethral stricture).
After you have had a cystoscopy, tell your doctor if:
 Pain or bleeding is severe.
 Any pain or bleeding lasts longer than two days.
 You develop symptoms of infection.
 If you are unable to pass urine.
What can I expect when I get home?
You will find it uncomfortable to pass urine for the first 24 hours. This discomfort should improve
as time goes by. If it is getting worse or you are finding it difficult to pass water, or you are feeling
feverish or unwell it is important that you tell your GP, (General Practitioner) or attend the A&E
Department.
Can I do everything as normal?
You can return to normal activity straight after the cystoscopy ,unless you are seeing blood in the
urine. If you see blood avoid heavy exercise until the bleeding has settled.
Further Information
For general queries about
flexible cystoscopies contact
the Urology Centre
Tel: 0151 600 1564.
Author: Urology
Department
Date: October 2008
Review Date: October
2010.
For clinical questions specific
to your case, telephone the
secretary of your Urology
Consultant.
This leaflet is available in large print, audio / computer disc, Braille,
and other languages on request.